Case Study: Diet for a Patient with Chronic Hunger, Iron Deficiency Anemia, and Lead Poisoning
Jonathan, a two-and-a-half-year-old, lives with his mother and brothers at his grandmother's house in Chicago. His mother, Anita, works at a pharmacy to support the family. Jonathan spends his days at home with his grandmother. While Anita works, his grandmother brings the boys to nearby congregate W.I.C (Women, Infants, and Children Program) site for a hot meal. Jonathan's favorite foods are French fries and strawberry milkshake. He drinks about four glasses (32ozs) of whole milk per day. He also loves grilled cheese sandwiches.
At his W.I.C appointment, the nutritionist asks Anita about Jonathan's food intake and plots his weight and height on growth charts for her to see. She works with Anita on goals for improving Jonathan's nutritional status. The statistics are as follows:
Date of W.I.C Appointment Jonathan's Age Jonathan's Height Jonathan's Weight Lab Values: Hemoglobin Lab Values: Lead
8/1/05 30 months 35.5 inches 27 lbs 10.3 10.2
5/2/05 27 months 35 inches 26.5 lbs
2/4/05 24 months 34.5 inches 26 lbs
Based on the information in Jonathan's case study, complete the following tasks:
Step 1: Assessment of nutritional status.
Your first step is to evaluate the anthropometric and biochemical data that is provided in the table above. Do this using the CDC growth grids for infant boys from the day of their birth until they are 36 months old. Plot Jonathan's weight/age, length/age and weight/length in a graph.
1.What do you notice about Jonathan's rate of growth over the past six months?
Note: The growth charts can be found in Appendix the textbook Foundations and clinical applications of nutrition: A nursing approach.
Step 2: Identify nutritional risk factors.
Nutritional risk factors are any conditions that place a person at risk for malnutrition. The risk may be related to the patient's age, weight, lab values, diet, economics, etc.
Using Nursing Diagnoses related to nutrition, if possible, (see NANDA in your text) list all of Jonathan's nutritional risk factors. Identify additional risk factors that are not on the NANDA list.
Indicate which of his nutritional problems are identified in Healthy People 2010: Nutrition and Weight Objectives.
Note: The Healthy People 2010: Nutrition and Weight Objectives can be found in your text or by going to the following Web site and scrolling down to appendix 19: Identify nursing interventions.
1.What are the possible nursing interventions directed at Jonathan's nutritional risk factors?
2.What diet recommendations would you explore with Anita? Is milk a good source of iron? What are the nutritional imbalances that might be associated with the milk intake? Can you make recommendations that would improve his calorie, iron, and zinc intake? How would this affect his lead absorption?
3.Would you make any healthcare referrals on his behalf?
Step 4: Monitor outcomes.
1.What outcomes would you like to see?
2.What would be a reasonable time frame to monitor intervention outcomes?
How would you like us to help you with this assignment?
Assignment 2: Case Study
Case Study: Diet for a Patient with Chronic Hunger, Iron Deficiency Anemia, and Lead Poisoning
Jonathan, a two-and-a-half-year-old, lives with his mother and brothers at his grandmother's house in Chicago. His mother, Anita, works at a pharmacy to support the family. Jonathan spends his days at home with his grandmother. While Anita works, his grandmother brings the boys to nearby congregate W.I.C (Women, Infants, and Children Program) site for a hot meal. Jonathan's favorite foods are French fries and strawberry milkshake. He drinks about four glasses (32ozs) of whole milk per day. He also loves grilled cheese sandwiches.
At his W.I.C appointment, the nutritionist asks Anita about Jonathan's food intake and plots his weight and height on growth charts for her to see. She works with Anita on goals for improving Jonathan's nutritional status. The statistics are as follows:
Date of W.I.C Appointment Jonathan's Age Jonathan's Height Jonathan's Weight Lab Values: Hemoglobin Lab Values: Lead
8/1/05 30 months 35.5 inches 27 lbs 10.3 10.2
5/2/05 27 months 35 inches 26.5 lbs
2/4/05 24 months 34.5 inches 26 lbs
Based on the information in Jonathan's case study, complete the following tasks:
Step 1: Assessment of nutritional status.
Your first step is to evaluate the anthropometric and biochemical data that is provided in the table above. Do this using the CDC growth grids for infant boys from the day of their birth until they are 36 months old. Plot Jonathan's weight/age, length/age and weight/length in a graph.
1.What do you notice about Jonathan's rate of growth over the past six months?
Note: The growth charts can be found in Appendix the textbook Foundations and clinical applications of nutrition: A nursing approach.
Step 2: Identify nutritional risk factors.
Nutritional risk factors are any conditions that place a person at risk for malnutrition. The risk may be related to the patient's age, weight, lab values, diet, economics, etc.
Using Nursing Diagnoses related to nutrition, if possible, (see NANDA in your text) list all of Jonathan's nutritional risk factors. Identify additional risk factors that are not on the NANDA list.
Indicate which of his nutritional problems are identified in Healthy People 2010: Nutrition and Weight Objectives.
Step 3: Identify nursing interventions.
1.What are the possible nursing interventions directed at Jonathan's nutritional risk factors?
2.What diet recommendations would you explore with Anita? Is milk a good source of iron? What are the nutritional imbalances that might be associated with the milk intake? Can you make recommendations that would improve his calorie, iron, and zinc intake? How would this affect his lead absorption?
3.Would you make any healthcare referrals on his behalf?
Step 4: Monitor outcomes.
1.What outcomes would you like to see?
2.What would be a reasonable time frame to monitor intervention outcomes?
Need the answers
could you please answer the post above for a assignment
Case Study: Diet for a Patient with Chronic Hunger, Iron Deficiency Anemia, and Lead Poisoning
Jonathan, a two-and-a-half-year-old, lives with his mother and brothers at his grandmother's house in Chicago. His mother, Anita, works at a pharmacy to support the family. Jonathan spends his days at home with his grandmother. While Anita works, his grandmother brings the boys to nearby congregate W.I.C (Women, Infants, and Children Program) site for a hot meal. Jonathan's favorite foods are French fries and strawberry milkshake. He drinks about four glasses (32ozs) of whole milk per day. He also loves grilled cheese sandwiches.
At his W.I.C appointment, the nutritionist asks Anita about Jonathan's food intake and plots his weight and height on growth charts for her to see. She works with Anita on goals for improving Jonathan's nutritional status. The statistics are as follows:
Date of W.I.C Appointment
Jonathan's Age
Jonathan's Height
Jonathan's Weight
Lab Values: Hemoglobin
Lab Values: Lead
8/1/05
30 months
35.5 inches
27 lbs
10.3
10.2
5/2/05
27 months
35 inches
26.5 lbs
2/4/05
24 months
34.5 inches
26 lbs
Based on the information in Jonathan's case study, complete the following tasks:
Step 1: Assessment of nutritional status.
Step 1: Assessment of nutritional status.
To evaluate Jonathan's nutritional status, we need to plot his weight/age, length/age, and weight/length on the CDC growth grids for infant boys. This will help us understand his rate of growth over the past six months.
By comparing the provided data with the growth charts, we can observe Jonathan's rate of growth:
- On 2/4/05, at 24 months of age, Jonathan's weight was 26 lbs and his height was 34.5 inches.
- On 5/2/05, at 27 months of age, Jonathan's weight was 26.5 lbs and his height was 35 inches.
- On 8/1/05, at 30 months of age, Jonathan's weight was 27 lbs and his height was 35.5 inches.
By plotting these values on the growth charts, we can see if Jonathan's growth is within the expected range for his age.
Step 2: Identify nutritional risk factors.
Nutritional risk factors are conditions that put a person at risk for malnutrition. In Jonathan's case, we can identify several nutritional risk factors:
Some possible nutritional risk factors based on NANDA (North American Nursing Diagnosis Association) related to nutrition:
- Inadequate dietary intake related to limited food choices and preference for unhealthy foods.
- Iron deficiency related to inadequate dietary iron intake.
- Lead poisoning related to exposure to lead.
Additional risk factors not on the NANDA list could include:
- Chronic hunger due to limited access to nutritious and diverse food options.
For the identification of nutritional problems in Healthy People 2010: Nutrition and Weight Objectives, please refer to your text or visit the relevant web site.
Step 3: Develop nursing interventions.
1. Possible nursing interventions directed at Jonathan's nutritional risk factors:
- Provide nutritional education to Anita regarding the importance of a balanced diet for Jonathan's growth and development.
- Encourage Anita to offer a variety of nutrient-rich foods, such as fruits, vegetables, whole grains, and lean proteins, to Jonathan.
- Discuss the negative impact of excessive milk intake on Jonathan's iron absorption and recommend limiting milk consumption to improve iron absorption.
- Suggest alternative iron-rich foods to improve Jonathan's iron intake, such as lean meats, beans, fortified cereals, and dark leafy greens.
- Provide guidance on reducing Jonathan's exposure to lead, such as identifying potential sources of lead in the home and ensuring proper hygiene practices.
2. Diet recommendations and nutritional imbalances:
- Milk is not a good source of iron. In fact, excessive milk intake can hinder iron absorption due to its calcium content.
- Nutritional imbalances associated with excessive milk intake are low iron and zinc levels, as well as potential deficiencies in other nutrients.
- Recommendations to improve calorie, iron, and zinc intake include incorporating iron-rich foods and zinc sources into Jonathan's diet, while reducing his milk consumption.
Regarding lead absorption:
- A diet high in calcium, iron, and zinc can help reduce lead absorption in the body.
- By following the recommendations to improve Jonathan's iron and zinc intake, his lead absorption may decrease.
Step 4: Monitor outcomes.
1. Desired outcomes for Jonathan:
- Improvement in weight and height, with growth rates within the expected range based on the CDC growth charts.
- Increase in hemoglobin levels, indicating an improvement in iron deficiency anemia.
- Reduction in blood lead levels, indicating a decrease in lead poisoning.
2. Reasonable time frame for monitoring intervention outcomes:
- It is essential to monitor the outcomes periodically to assess the effectiveness of the interventions.
- Time frames will depend on the severity of the existing nutritional problems and the rate of improvement observed.
- Regular follow-ups with healthcare professionals can help determine an appropriate time frame for monitoring intervention outcomes.